Swallowing-induced tachyarrhythmias is a rare phenomenon, with only over 50 cases reported in the literature. We reported a unique case of swallowing-induced paroxysmal atrial fibrillation(AF) associated with Type IIB neurocardiogenic syncope. A 71-year-old woman presented with intermittent palpitation happening mostly at night time and during meal when she swallowed food. The symptom of palpitation could be relieved by walking exercise. Paroxysmal atrial fibrillation was documented during palpitation. She also had an episode of syncope. Brief episodes of AF could be easily induced by drinking water in room temperature. Tilting table test results showed a very short duration of repetitive premature atrial contractions (PACs) followed by cardiac asystole up to 4.86 seconds after provocation with sublingual nitroglycerin. Under the diagnosis of swallowinginduced AF and Type IIB neurocardiogenic syncope, she was successfully treated with a DDDR pacemaker and oral propafenone 150mg three times a day. The clinical symptoms were under well control and there was no more syncope after treatment.